Skin cancer is the common name for common malignant diseases (neoplasias). They can be divided into two large groups: non-melanoma skin cancer and melanoma.
Causes of skin cancer
The reasons for the development of skin cancer are currently not precisely established. However, there are so-called risk factors, the presence of which in humans increases the risk of developing basal cell carcinoma. These predisposing factors include:
- A visit to the solarium for a long time;
- Bright skin;
- The tendency to form sunburn;
- Celtic origin;
- Work with arsenic compounds;
- Drinking water containing arsenic;
- Inhalation of products of burning oil shale;
- Reduced immunity;
- The presence of pigmented keratoderma;
- The presence of Gorling-Holtz syndrome;
- Frequent and prolonged exposure to the sun, including work in direct sunlight;
- The tendency to form freckles after a short exposure to direct sunlight;
- Frequent and prolonged contact with carcinogens such as soot, tar, paraffin wax, bitumen, creosote and oil products;
- Exposure to ionizing radiation, including previous radiation therapy;
- Scars on the skin;
- Ulcers on the skin.
Stages of skin cancer
Initial (zero) – the tumor is clearly defined, does not grow into the surrounding tissue (carcinoma in situ). No tumor cells are found in peripheral lymph nodes and other organs;
- Stage 1 – the tumor is less than 2 cm in diameter, has only one unfavorable sign, metastases are not detected;
- Stage 2 – the tumor is more than 2 cm in diameter, has 2 or more unfavorable signs, there are no metastases;
- Stage 3 – the tumor has grown in the adjacent bone tissue (jaw or temporal bone), but there are no metastases. The tumor can be of any size with any number of adverse signs, but if there are metastases in the nearest lymph node, the size of which is less than 3 cm, then this is stage 3 cancer;
- Stage 4 – is diagnosed in four cases: the size of the lymph node located on the same side as the tumor (together with metastases) is more than 3 cm; cancer has spread to several lymph nodes or to one, but its size is more than 6 cm; the tumor has grown in the bone (except for the jaw and temporal); there are metastases in other organs.
The signs of skin cancer can be very diverse. The common symptoms of basal cell carcinoma include:
- bleeding, oozing ulcers, not healing for several weeks;
- a reddened thickened area of the skin that can itch, crust, but very rarely hurts;
- bright pink, red or pearl white bump;
- colorless neoplasm, similar to a blister;
- pink tubercle, the central part of which is ulcerated and covered with a crust;
- scarred, white, yellowish or waxy skin, often with uneven and unexpressed edges.
Squamous cell carcinoma most often looks like a crusty, bleeding area, which may also look like:
- open sores that do not heal for several weeks;
- a tubercle with a rough surface and a hollow in the middle.
If cancer affects nearby nerves, the disease can be accompanied by itching, pain, a feeling of numbness, burning, “goosebumps” under the skin.
In rare cases, there may be no complaints at all. And sometimes one or more of these signs indicate completely different diseases.
The main diagnostic measures for confirming skin cancer include:
- Dermatoscopy is a visual assessment of a tumor approximated using special magnifying glasses;
- Thermography is a measurement of neoplasm temperature;
- A smear is a method in which a glass slide is applied to an ulcer freed from crusts with light pressure. Several glasses are used and different parts of the alleged tumor. After that, the collected fingerprints are examined using microscopy;
- Scraping. Using a special wooden spatula, a certain amount of contents is scraped off from the bottom of the ulcerated surface and the material is transferred onto a glass slide with its subsequent study;
- Biopsy. A specialist takes cellular material from the depth of formation using a needle with a syringe. In the excisional variant, its excision is performed within the tissues that are not subject to the process. In the incisional variant, a large neoplasm is removed with the adjacent visually healthy area;
- Visualization methods are needed to clarify and verify the spread of the oncological process. These include ultrasound screening, examination with a computer tomography.
Diagnosis of melanoma cannot be made using a biopsy, as there is a high risk of cancer cells entering other body tissues.
Skin cancer treatment
The treatment plan is determined for each patient individually. Therapy is effective in 9 cases out of 10. The following options can be used:
- Skin cancer surgery is the main treatment. During surgery, the neoplasm is removed along with the adjacent visually healthy area. This reduces the risk of leaving individual cancer cells in the suture area, from which a new tumor will form. With extensive surgery, a skin transplant may be indicated. A type of surgical treatment is Mohs micrographic surgery: the tumor is removed in layers. Each of them is examined under a microscope. Layers are removed until pathologically altered tissues are observed in the samples;
- Radiation therapy (radiotherapy) is used when the affected area is very extensive or cannot be removed surgically. Sometimes radiotherapy is performed after surgery. Its purpose is to destroy the remaining cancer cells (adjuvant radiotherapy);
- Modern methods: cryodestruction, laser coagulation, and photodynamic therapy, in which a special cream is applied that increases the sensitivity of tumor cells to light;
- Medications are prescribed only for cancer that affects the upper layers of the skin. There are two types of anti-cancer creams: chemotherapeutic and immunostimulating. The most popular drugs used to treat skin cancer are Methotrexate, Leukeran, and Hydrea.
The so-called traditional methods of treating skin cancer is a reliable way to complications and neglected cases of the disease. Therefore, it is not recommended to use them.
Prognosis and complications of skin cancer
The prognosis for non-melanoma neoplasms is most often good. The outcome depends on the size of the tumor, the degree of its penetration into the deeper layers of the skin, adjacent bones, location and growth rate, the presence of metastases.
Basal cell carcinoma very rarely metastasizes and almost never leads to death. In rare cases, relapse may occur, so the course of treatment will have to be repeated.
Squamous cell carcinoma is rare but it can still metastasize to regional lymph nodes. It is treated well but there is a chance of relapse.
It is recommended that you follow some preventive measures for melanoma and other types of skin cancer:
- Limit your exposure to the sun as much as possible, especially during lunch hours;
- Protect your skin from direct sunlight;
- Study all the main and secondary signs of melanoma and, if possible, discuss them with your doctor;
- Regularly inspect the entire surface of the skin (the skin of the back and head should be examined by your friend or relative);
- See your doctor if you suspect any skin element.
Remember that it is important to be on alert, as this will help to detect skin cancer early. The timely treatment will help avoid fatal consequences. Take care of your health!